PURPOSE: The purpose of this study was to clarify attributes, antecedents, and consequences of female sexual subjectivity. METHODS: Walker and Avant's concept analysis process was used to analyze 27 studies from the current literature that relates to female sexual subjectivity. A systematic literature review of women's study in sociology, psychology, theology, law, health science, and nursing was reviewed. RESULTS: The defining attributes of female sexual subjectivity were sexual self-awareness, sexual decision making, sexual desire, and good sexual communication with partner. The antecedents of female sexual subjectivity were social environment, sexual education, sexual experience, and interpersonal relationship. The consequences of female sexual subjectivity were safe sex, prevention of sexual victimization, and sexual satisfaction. CONCLUSION: Female sexual subjectivity is defined as sexual self-awareness, sexual decision making, sexual desire to seek sexual pleasure and safety, and effective communication with partner in terms of sexual behavior, sexual experience and sexual health. Based on these results, a scale measuring female sexual subjectivity is needed.
Crime Victims ; Decision Making ; Education ; Female* ; Humans ; Jurisprudence ; Methods* ; Nursing ; Orgasm ; Pleasure ; Psychology ; Reproductive Health ; Safe Sex ; Sexual Behavior ; Social Environment ; Sociology ; Theology ; Walkers*

Objective: This study aimed to overview and assess the effectiveness of the policies and regulations that have governed new drug access in Korea, and to propose policies to enhance patient access to drugs, particularly for new innovative medicines. Methods: We approached drug access issues in two perspectives: approval lag (or availability) and reimbursement lag (or affordability). The issues were identified and evaluated through the review of literature, public documents, reports published by the government agencies and private organizations, and news articles. Results: To shorten approval lag, it is recommended to hire and train more reviewers at the Ministry of Food and Drug Safety. Increasing user fees to a realistic level can facilitate this process. To reduce reimbursement lag, flexible incremental cost-effectiveness ratio threshold, alternative cost-effectiveness evaluation, and establishment of funding source other than the national health insurance are identified as the areas to be improved. Conclusion The current policies and regulations had to be supplemented by new systems to drastically promote patient accessibility to new drugs, consequently in order to promote national public health.

Objective: This study aimed to overview and assess the effectiveness of the policies and regulations that have governed new drug access in Korea, and to propose policies to enhance patient access to drugs, particularly for new innovative medicines. Methods: We approached drug access issues in two perspectives: approval lag (or availability) and reimbursement lag (or affordability). The issues were identified and evaluated through the review of literature, public documents, reports published by the government agencies and private organizations, and news articles. Results: To shorten approval lag, it is recommended to hire and train more reviewers at the Ministry of Food and Drug Safety. Increasing user fees to a realistic level can facilitate this process. To reduce reimbursement lag, flexible incremental cost-effectiveness ratio threshold, alternative cost-effectiveness evaluation, and establishment of funding source other than the national health insurance are identified as the areas to be improved. Conclusion The current policies and regulations had to be supplemented by new systems to drastically promote patient accessibility to new drugs, consequently in order to promote national public health.

PURPOSE: The usability, user satisfaction, and impact of electronic nursing record (ENR) systems were investigated. METHODS: This mixed-method research was performed as a time-motion (TM) study and a survey which were carried out at six hospitals between August and November 2013. The TM study involved 108 nurses from medical, surgical, and intensive care units at each hospital, plus an additional 48 nurses who served as nonparticipating observers. In the survey, 1879 volunteer nurses completed the Impact of ENR Systems Scale, the System Usability Scale, and a global satisfaction scale. Qualitative and quantitative analyses were performed. RESULTS: The mean scores for the ENR impact, system usability, and satisfaction were 4.28 (out of 6), 58.62 (out of 100), and 74.31 (out of 100), respectively, and they differed significantly between hospitals (F=43.43, p<.001, F=53.08 and p<.001, and F=29.13 and p<.001, respectively). A workflow fragmentation assessment revealed different patterns of ENR system use among the included hospitals. Three user characteristics-educational background, practice period, and experience of using paper records-significantly affected the system usability and satisfaction scores. CONCLUSION: The system quality varied widely among the ENR systems. The generally low-to-moderate levels of system usability and user satisfaction suggest many opportunities for improvement.
Adult ; Female ; Humans ; Male ; *Nursing Records ; Nursing Staff, Hospital/*psychology ; Personal Satisfaction ; Surveys and Questionnaires ; *User-Computer Interface

OBJECTIVE: To investigate the immediate effect of a single session of whole body vibration (WBV) on lower extremity spasticity in children with cerebral palsy (CP). METHODS: Seventeen children with spastic CP were included. A single session of WBV was administered: 10-minute WBV, 1-minute rest, and 10-minute WBV. The effects of WBV were clinically assessed with the Modified Ashworth Scale (MAS) and Modified Tardieu Scale (MTS) before and immediately, 30 minutes, 1 hour, 2 hours, 3 hours, and 4 hours after WBV. RESULTS: Spasticity of the ankle plantarflexor, as assessed by MAS and MTS scores, was reduced after WBV. Post-hoc analysis demonstrated that, compared to baseline, the MAS significantly improved for a period of 1 hour after WBV, and the R1 and R2–R1 of the MTS significantly improved for a period of 2 hours after WBV. CONCLUSION: A single session of WBV improves spasticity of ankle plantarflexors for 1–2 hours in children with CP. Future studies are needed to test whether WBV is an effective preparation before physiotherapy and occupational therapy.
Ankle ; Cerebral Palsy* ; Child* ; Humans ; Lower Extremity ; Muscle Spasticity* ; Occupational Therapy ; Vibration*

The authors noticed that the original version of the paper contains typographical errors in Figs. 2 and 3.

PURPOSE: This study aimed to compare the oncologic and short-term outcomes of laparoscopic distal gastrectomy (LDG) and open distal gastrectomy (ODG) for advanced gastric cancer (AGC). MATERIALS AND METHODS: From July 2006 to November 2016, 384 patients underwent distal gastrectomy for AGC. Data on short- and long-term outcomes were prospectively collected and reviewed. Propensity score matching was applied at a ratio of 1:1 to compare the LDG and ODG groups. RESULTS: The operative times were longer for the LDG group than for the ODG group. However, the time to resumption of diet and the length of hospital stay were shorter in the LDG group than in the ODG group (4.7 vs. 5.6 days, P=0.049 and 9.6 vs. 11.5 days, P=0.035, respectively). The extent of lymph node dissection in the LDG group was more limited than in the ODG group (P=0.002), although there was no difference in the number of retrieved lymph nodes between the 2 groups. The 3-year overall survival rates were 98% and 86.9% (P=0.018), and the 3-year recurrence-free survival rates were 86.3% and 75.3% (P=0.259), respectively, in the LDG and ODG groups. CONCLUSIONS: LDG is safe and feasible for AGC, with earlier recovery after surgery and long-term oncologic outcomes comparable to those of ODG.
Diet ; Disease-Free Survival ; Gastrectomy ; Humans ; Laparoscopy ; Length of Stay ; Lymph Node Excision ; Lymph Nodes ; Operative Time ; Propensity Score ; Prospective Studies ; Stomach Neoplasms ; Survival Rate

PURPOSE: We aimed to evaluate the clinical outcomes and determine the degree of postoperative pain associated with the location of mini-laparotomy sites in gastric cancer patients who underwent laparoscopic-assisted distal gastrectomy (LADG) or totally laparoscopic distal gastrectomy (TLDG). METHODS: Between November 2011 and December 2016, 153 patients who underwent surgery for gastric cancer at Kyung Hee University Hospital at Gangdong were reviewed retrospectively. We divided the patients into LADG with epigastric incision, TLDG with umbilical incision (TLDG_U), and TLDG with Pfannenstiel incision (TLDG_P) groups according to the location of incision for anastomosis and specimen removal. There were 37 cases in the LADG group, 85 in the TLDG_U group, and 31 in the TLDG_P group. The clinical characteristics, numeric rating scale (NRS) scores, and postoperative analgesic usage for 7 days of the three groups were compared. RESULTS: There was no statistically significant difference in clinical characteristics including age, sex, body mass index (BMI), TNM staging, and complications among the three groups. There was no significant difference in the amount of total analgesics received; however, the TLDG_P group received more analgesics (5.26±5.053, p=0.412) during the first 7 postoperative days. The TLDG_P group showed higher NRS scores on postoperative days 0, 2, 3, 4, and 5 (p=0.04, 0.001, 0.003, 0.006, and 0.002 respectively). CONCLUSION: Laparoscopic distal gastrectomy can be performed through various incision sites for increasing the safety of mini-laparotomy. However, a Pfannenstiel incision was shown to be more painful than other incisions.
Analgesics ; Body Mass Index ; Gastrectomy ; Humans ; Neoplasm Staging ; Pain, Postoperative ; Retrospective Studies ; Stomach Neoplasms